|
HC ADAPTER PERFUSION STERILE
|
Facility
|
IP
|
$90.00
|
|
| Hospital Charge Code |
27000677
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.89 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: BCBS Trust/PPO |
$69.55
|
| Rate for Payer: BCN Commercial |
$69.55
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.20
|
| Rate for Payer: UHC Core |
$75.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC ADAPTOR PERFUSION
|
Facility
|
OP
|
$12.00
|
|
| Hospital Charge Code |
27000264
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.85 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Aetna Commercial |
$10.20
|
| Rate for Payer: Aetna Medicare |
$3.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.75
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: BCBS MAPPO |
$3.00
|
| Rate for Payer: BCBS Trust/PPO |
$9.33
|
| Rate for Payer: BCN Commercial |
$9.33
|
| Rate for Payer: BCN Medicare Advantage |
$3.00
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$10.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.00
|
| Rate for Payer: Healthscope Commercial |
$10.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.20
|
| Rate for Payer: PACE Senior Care Partners |
$2.85
|
| Rate for Payer: PACE SWMI |
$3.00
|
| Rate for Payer: PHP Commercial |
$10.20
|
| Rate for Payer: PHP Medicare Advantage |
$3.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.44
|
| Rate for Payer: Priority Health Medicare |
$3.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.56
|
| Rate for Payer: UHC Core |
$10.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.00
|
| Rate for Payer: UHC Medicare Advantage |
$3.09
|
| Rate for Payer: VA VA |
$3.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.00
|
|
|
HC ADAPTOR PERFUSION
|
Facility
|
IP
|
$12.00
|
|
| Hospital Charge Code |
27000264
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.32 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Aetna Commercial |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$9.27
|
| Rate for Payer: BCN Commercial |
$9.27
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$10.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.60
|
| Rate for Payer: Healthscope Commercial |
$10.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.20
|
| Rate for Payer: PHP Commercial |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.56
|
| Rate for Payer: UHC Core |
$10.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.00
|
|
|
HC ADD. ABLATION
|
Facility
|
OP
|
$8,727.45
|
|
|
Service Code
|
CPT 93655
|
| Hospital Charge Code |
48100093
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,072.77 |
| Max. Negotiated Rate |
$7,854.70 |
| Rate for Payer: Aetna Commercial |
$7,418.33
|
| Rate for Payer: Aetna Medicare |
$2,269.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,727.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,727.33
|
| Rate for Payer: BCBS Complete |
$3,490.98
|
| Rate for Payer: BCBS MAPPO |
$2,181.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,785.59
|
| Rate for Payer: BCN Commercial |
$6,785.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,181.86
|
| Rate for Payer: Cash Price |
$6,981.96
|
| Rate for Payer: Cofinity Commercial |
$7,505.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,981.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,181.86
|
| Rate for Payer: Healthscope Commercial |
$7,854.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,545.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,290.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,509.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,418.33
|
| Rate for Payer: PACE Senior Care Partners |
$2,072.77
|
| Rate for Payer: PACE SWMI |
$2,181.86
|
| Rate for Payer: PHP Commercial |
$7,418.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,181.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,109.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,592.88
|
| Rate for Payer: Priority Health Medicare |
$2,181.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,322.87
|
| Rate for Payer: Railroad Medicare Medicare |
$2,181.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,680.16
|
| Rate for Payer: UHC Core |
$7,287.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,181.86
|
| Rate for Payer: UHC Medicare Advantage |
$2,247.32
|
| Rate for Payer: VA VA |
$2,181.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,545.59
|
|
|
HC ADD. ABLATION
|
Facility
|
IP
|
$8,727.45
|
|
|
Service Code
|
CPT 93655
|
| Hospital Charge Code |
48100093
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,322.87 |
| Max. Negotiated Rate |
$7,854.70 |
| Rate for Payer: Aetna Commercial |
$7,418.33
|
| Rate for Payer: BCBS Trust/PPO |
$6,744.57
|
| Rate for Payer: BCN Commercial |
$6,744.57
|
| Rate for Payer: Cash Price |
$6,981.96
|
| Rate for Payer: Cofinity Commercial |
$7,505.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,981.96
|
| Rate for Payer: Healthscope Commercial |
$7,854.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,545.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,418.33
|
| Rate for Payer: PHP Commercial |
$7,418.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,109.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,592.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,322.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,680.16
|
| Rate for Payer: UHC Core |
$7,287.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,545.59
|
|
|
HC ADD.AFIB ABL AFTER PVI
|
Facility
|
IP
|
$8,727.45
|
|
|
Service Code
|
CPT 93657
|
| Hospital Charge Code |
48100095
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,322.87 |
| Max. Negotiated Rate |
$7,854.70 |
| Rate for Payer: Aetna Commercial |
$7,418.33
|
| Rate for Payer: BCBS Trust/PPO |
$6,744.57
|
| Rate for Payer: BCN Commercial |
$6,744.57
|
| Rate for Payer: Cash Price |
$6,981.96
|
| Rate for Payer: Cofinity Commercial |
$7,505.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,981.96
|
| Rate for Payer: Healthscope Commercial |
$7,854.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,545.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,418.33
|
| Rate for Payer: PHP Commercial |
$7,418.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,109.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,592.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,322.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,680.16
|
| Rate for Payer: UHC Core |
$7,287.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,545.59
|
|
|
HC ADD.AFIB ABL AFTER PVI
|
Facility
|
OP
|
$8,727.45
|
|
|
Service Code
|
CPT 93657
|
| Hospital Charge Code |
48100095
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,072.77 |
| Max. Negotiated Rate |
$7,854.70 |
| Rate for Payer: Aetna Commercial |
$7,418.33
|
| Rate for Payer: Aetna Medicare |
$2,269.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,727.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,727.33
|
| Rate for Payer: BCBS Complete |
$3,490.98
|
| Rate for Payer: BCBS MAPPO |
$2,181.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,785.59
|
| Rate for Payer: BCN Commercial |
$6,785.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,181.86
|
| Rate for Payer: Cash Price |
$6,981.96
|
| Rate for Payer: Cofinity Commercial |
$7,505.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,981.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,181.86
|
| Rate for Payer: Healthscope Commercial |
$7,854.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,545.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,290.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,509.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,418.33
|
| Rate for Payer: PACE Senior Care Partners |
$2,072.77
|
| Rate for Payer: PACE SWMI |
$2,181.86
|
| Rate for Payer: PHP Commercial |
$7,418.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,181.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,109.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,592.88
|
| Rate for Payer: Priority Health Medicare |
$2,181.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,322.87
|
| Rate for Payer: Railroad Medicare Medicare |
$2,181.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,680.16
|
| Rate for Payer: UHC Core |
$7,287.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,181.86
|
| Rate for Payer: UHC Medicare Advantage |
$2,247.32
|
| Rate for Payer: VA VA |
$2,181.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,545.59
|
|
|
HC ADDL DOSE TC99M NON HEU
|
Facility
|
IP
|
$53.55
|
|
|
Service Code
|
HCPCS Q9969
|
| Hospital Charge Code |
34300036
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$32.66 |
| Max. Negotiated Rate |
$48.20 |
| Rate for Payer: Aetna Commercial |
$45.52
|
| Rate for Payer: BCBS Trust/PPO |
$41.38
|
| Rate for Payer: BCN Commercial |
$41.38
|
| Rate for Payer: Cash Price |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$46.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$48.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.52
|
| Rate for Payer: PHP Commercial |
$45.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.12
|
| Rate for Payer: UHC Core |
$44.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.16
|
|
|
HC ADDL DOSE TC99M NON HEU
|
Facility
|
OP
|
$53.55
|
|
|
Service Code
|
HCPCS Q9969
|
| Hospital Charge Code |
34300036
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$7.38 |
| Max. Negotiated Rate |
$48.20 |
| Rate for Payer: Aetna Commercial |
$45.52
|
| Rate for Payer: Aetna Medicare |
$13.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.73
|
| Rate for Payer: BCBS Complete |
$7.75
|
| Rate for Payer: BCBS MAPPO |
$13.39
|
| Rate for Payer: BCBS Trust/PPO |
$41.64
|
| Rate for Payer: BCN Commercial |
$41.64
|
| Rate for Payer: BCN Medicare Advantage |
$13.39
|
| Rate for Payer: Cash Price |
$42.84
|
| Rate for Payer: Cash Price |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$46.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$48.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.16
|
| Rate for Payer: Mclaren Medicaid |
$7.38
|
| Rate for Payer: Meridian Medicaid |
$7.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.52
|
| Rate for Payer: PACE Senior Care Partners |
$12.72
|
| Rate for Payer: PACE SWMI |
$13.39
|
| Rate for Payer: PHP Commercial |
$45.52
|
| Rate for Payer: PHP Medicare Advantage |
$13.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.59
|
| Rate for Payer: Priority Health Medicare |
$13.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.66
|
| Rate for Payer: Railroad Medicare Medicare |
$13.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.12
|
| Rate for Payer: UHC Core |
$44.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.39
|
| Rate for Payer: UHC Medicare Advantage |
$13.79
|
| Rate for Payer: VA VA |
$13.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.16
|
|
|
HC ADENOVIRUS ANTIBODY
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200219
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna Medicare |
$26.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.88
|
| Rate for Payer: BCBS Complete |
$9.97
|
| Rate for Payer: BCBS MAPPO |
$25.50
|
| Rate for Payer: BCBS Trust/PPO |
$79.30
|
| Rate for Payer: BCN Commercial |
$79.30
|
| Rate for Payer: BCN Medicare Advantage |
$25.50
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.50
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Mclaren Medicaid |
$9.50
|
| Rate for Payer: Meridian Medicaid |
$9.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PACE Senior Care Partners |
$24.22
|
| Rate for Payer: PACE SWMI |
$25.50
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: PHP Medicare Advantage |
$25.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.74
|
| Rate for Payer: Priority Health Medicare |
$25.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.21
|
| Rate for Payer: Railroad Medicare Medicare |
$25.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.76
|
| Rate for Payer: UHC Core |
$85.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.50
|
| Rate for Payer: UHC Medicare Advantage |
$26.26
|
| Rate for Payer: VA VA |
$25.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
HC ADENOVIRUS ANTIBODY
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200219
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$62.21 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: BCBS Trust/PPO |
$78.83
|
| Rate for Payer: BCN Commercial |
$78.83
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.76
|
| Rate for Payer: UHC Core |
$85.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
HC ADENOVIRUS PCR
|
Facility
|
OP
|
$100.98
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600279
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.98 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: Aetna Medicare |
$26.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.56
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$25.24
|
| Rate for Payer: BCBS Trust/PPO |
$78.51
|
| Rate for Payer: BCN Commercial |
$78.51
|
| Rate for Payer: BCN Medicare Advantage |
$25.24
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.24
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.74
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.83
|
| Rate for Payer: PACE Senior Care Partners |
$23.98
|
| Rate for Payer: PACE SWMI |
$25.24
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: PHP Medicare Advantage |
$25.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.85
|
| Rate for Payer: Priority Health Medicare |
$25.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.59
|
| Rate for Payer: Railroad Medicare Medicare |
$25.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.86
|
| Rate for Payer: UHC Core |
$84.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.24
|
| Rate for Payer: UHC Medicare Advantage |
$26.00
|
| Rate for Payer: VA VA |
$25.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.74
|
|
|
HC ADENOVIRUS PCR
|
Facility
|
IP
|
$100.98
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600279
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$61.59 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: BCBS Trust/PPO |
$78.04
|
| Rate for Payer: BCN Commercial |
$78.04
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.78
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.83
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.86
|
| Rate for Payer: UHC Core |
$84.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.74
|
|
|
HC ADHESIVE RELEASER 50 ML
|
Facility
|
IP
|
$26.08
|
|
|
Service Code
|
HCPCS A4455
|
| Hospital Charge Code |
27000626
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$23.47 |
| Rate for Payer: Aetna Commercial |
$22.17
|
| Rate for Payer: BCBS Trust/PPO |
$20.15
|
| Rate for Payer: BCN Commercial |
$20.15
|
| Rate for Payer: Cash Price |
$20.86
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.86
|
| Rate for Payer: Healthscope Commercial |
$23.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.17
|
| Rate for Payer: PHP Commercial |
$22.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.95
|
| Rate for Payer: UHC Core |
$21.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.56
|
|
|
HC ADHESIVE RELEASER 50 ML
|
Facility
|
OP
|
$26.08
|
|
|
Service Code
|
HCPCS A4455
|
| Hospital Charge Code |
27000626
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.19 |
| Max. Negotiated Rate |
$23.47 |
| Rate for Payer: Aetna Commercial |
$22.17
|
| Rate for Payer: Aetna Medicare |
$6.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.15
|
| Rate for Payer: BCBS Complete |
$10.43
|
| Rate for Payer: BCBS MAPPO |
$6.52
|
| Rate for Payer: BCBS Trust/PPO |
$20.28
|
| Rate for Payer: BCN Commercial |
$20.28
|
| Rate for Payer: BCN Medicare Advantage |
$6.52
|
| Rate for Payer: Cash Price |
$20.86
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.52
|
| Rate for Payer: Healthscope Commercial |
$23.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.17
|
| Rate for Payer: PACE Senior Care Partners |
$6.19
|
| Rate for Payer: PACE SWMI |
$6.52
|
| Rate for Payer: PHP Commercial |
$22.17
|
| Rate for Payer: PHP Medicare Advantage |
$6.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$6.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.91
|
| Rate for Payer: Railroad Medicare Medicare |
$6.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.95
|
| Rate for Payer: UHC Core |
$21.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.52
|
| Rate for Payer: UHC Medicare Advantage |
$6.72
|
| Rate for Payer: VA VA |
$6.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.56
|
|
|
HC ADL TRAINING EA 15 MIN
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
42000030
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$60.97 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: BCBS Trust/PPO |
$77.25
|
| Rate for Payer: BCN Commercial |
$77.25
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.97
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.96
|
| Rate for Payer: UHC Core |
$83.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
|
HC ADL TRAINING EA 15 MIN
|
Facility
|
OP
|
$99.96
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
42000030
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.74 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna Medicare |
$25.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.24
|
| Rate for Payer: BCBS Complete |
$39.98
|
| Rate for Payer: BCBS MAPPO |
$24.99
|
| Rate for Payer: BCBS Trust/PPO |
$77.72
|
| Rate for Payer: BCN Commercial |
$77.72
|
| Rate for Payer: BCN Medicare Advantage |
$24.99
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.99
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.97
|
| Rate for Payer: PACE Senior Care Partners |
$23.74
|
| Rate for Payer: PACE SWMI |
$24.99
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: PHP Medicare Advantage |
$24.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.97
|
| Rate for Payer: Priority Health Medicare |
$24.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.97
|
| Rate for Payer: Railroad Medicare Medicare |
$24.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.96
|
| Rate for Payer: UHC Core |
$83.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.99
|
| Rate for Payer: UHC Medicare Advantage |
$25.74
|
| Rate for Payer: VA VA |
$24.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
|
HC ADMIN INTRAPULMONARY SURFACTANT
|
Facility
|
OP
|
$574.00
|
|
|
Service Code
|
CPT 94610
|
| Hospital Charge Code |
46000034
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$136.32 |
| Max. Negotiated Rate |
$516.60 |
| Rate for Payer: Aetna Commercial |
$487.90
|
| Rate for Payer: Aetna Medicare |
$149.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.38
|
| Rate for Payer: BCBS Complete |
$146.91
|
| Rate for Payer: BCBS MAPPO |
$143.50
|
| Rate for Payer: BCBS Trust/PPO |
$446.28
|
| Rate for Payer: BCN Commercial |
$446.28
|
| Rate for Payer: BCN Medicare Advantage |
$143.50
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$493.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$459.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.50
|
| Rate for Payer: Healthscope Commercial |
$516.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.50
|
| Rate for Payer: Mclaren Medicaid |
$139.92
|
| Rate for Payer: Meridian Medicaid |
$146.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$487.90
|
| Rate for Payer: PACE Senior Care Partners |
$136.32
|
| Rate for Payer: PACE SWMI |
$143.50
|
| Rate for Payer: PHP Commercial |
$487.90
|
| Rate for Payer: PHP Medicare Advantage |
$143.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$499.38
|
| Rate for Payer: Priority Health Medicare |
$143.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.08
|
| Rate for Payer: Railroad Medicare Medicare |
$143.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$505.12
|
| Rate for Payer: UHC Core |
$479.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.50
|
| Rate for Payer: UHC Medicare Advantage |
$147.80
|
| Rate for Payer: VA VA |
$143.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.50
|
|
|
HC ADMIN INTRAPULMONARY SURFACTANT
|
Facility
|
IP
|
$574.00
|
|
|
Service Code
|
CPT 94610
|
| Hospital Charge Code |
46000034
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$350.08 |
| Max. Negotiated Rate |
$516.60 |
| Rate for Payer: Aetna Commercial |
$487.90
|
| Rate for Payer: BCBS Trust/PPO |
$443.59
|
| Rate for Payer: BCN Commercial |
$443.59
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$493.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$459.20
|
| Rate for Payer: Healthscope Commercial |
$516.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$487.90
|
| Rate for Payer: PHP Commercial |
$487.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$499.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$505.12
|
| Rate for Payer: UHC Core |
$479.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.50
|
|
|
HC ADMIN RSV MONOC ANTB IM INJ
|
Facility
|
IP
|
$83.04
|
|
|
Service Code
|
CPT 96381
|
| Hospital Charge Code |
77100066
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$50.65 |
| Max. Negotiated Rate |
$74.74 |
| Rate for Payer: Aetna Commercial |
$70.58
|
| Rate for Payer: BCBS Trust/PPO |
$64.17
|
| Rate for Payer: BCN Commercial |
$64.17
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cofinity Commercial |
$71.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.43
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.58
|
| Rate for Payer: PHP Commercial |
$70.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.08
|
| Rate for Payer: UHC Core |
$69.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.28
|
|
|
HC ADMIN RSV MONOC ANTB IM INJ
|
Facility
|
OP
|
$83.04
|
|
|
Service Code
|
CPT 96381
|
| Hospital Charge Code |
77100066
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$19.72 |
| Max. Negotiated Rate |
$74.74 |
| Rate for Payer: Aetna Commercial |
$70.58
|
| Rate for Payer: Aetna Medicare |
$21.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.95
|
| Rate for Payer: BCBS Complete |
$33.22
|
| Rate for Payer: BCBS MAPPO |
$20.76
|
| Rate for Payer: BCBS Trust/PPO |
$64.56
|
| Rate for Payer: BCN Commercial |
$64.56
|
| Rate for Payer: BCN Medicare Advantage |
$20.76
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cofinity Commercial |
$71.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.76
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.58
|
| Rate for Payer: PACE Senior Care Partners |
$19.72
|
| Rate for Payer: PACE SWMI |
$20.76
|
| Rate for Payer: PHP Commercial |
$70.58
|
| Rate for Payer: PHP Medicare Advantage |
$20.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.24
|
| Rate for Payer: Priority Health Medicare |
$20.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.65
|
| Rate for Payer: Railroad Medicare Medicare |
$20.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.08
|
| Rate for Payer: UHC Core |
$69.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.76
|
| Rate for Payer: UHC Medicare Advantage |
$21.38
|
| Rate for Payer: VA VA |
$20.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.28
|
|
|
HC ADMIN RSV MONOC ANTB IM W/COUNSELING
|
Facility
|
OP
|
$83.04
|
|
|
Service Code
|
CPT 96380
|
| Hospital Charge Code |
77100065
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$19.72 |
| Max. Negotiated Rate |
$74.74 |
| Rate for Payer: Aetna Commercial |
$70.58
|
| Rate for Payer: Aetna Medicare |
$21.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.95
|
| Rate for Payer: BCBS Complete |
$33.22
|
| Rate for Payer: BCBS MAPPO |
$20.76
|
| Rate for Payer: BCBS Trust/PPO |
$64.56
|
| Rate for Payer: BCN Commercial |
$64.56
|
| Rate for Payer: BCN Medicare Advantage |
$20.76
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cofinity Commercial |
$71.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.76
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.58
|
| Rate for Payer: PACE Senior Care Partners |
$19.72
|
| Rate for Payer: PACE SWMI |
$20.76
|
| Rate for Payer: PHP Commercial |
$70.58
|
| Rate for Payer: PHP Medicare Advantage |
$20.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.24
|
| Rate for Payer: Priority Health Medicare |
$20.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.65
|
| Rate for Payer: Railroad Medicare Medicare |
$20.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.08
|
| Rate for Payer: UHC Core |
$69.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.76
|
| Rate for Payer: UHC Medicare Advantage |
$21.38
|
| Rate for Payer: VA VA |
$20.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.28
|
|
|
HC ADMIN RSV MONOC ANTB IM W/COUNSELING
|
Facility
|
IP
|
$83.04
|
|
|
Service Code
|
CPT 96380
|
| Hospital Charge Code |
77100065
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$50.65 |
| Max. Negotiated Rate |
$74.74 |
| Rate for Payer: Aetna Commercial |
$70.58
|
| Rate for Payer: BCBS Trust/PPO |
$64.17
|
| Rate for Payer: BCN Commercial |
$64.17
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cofinity Commercial |
$71.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.43
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.58
|
| Rate for Payer: PHP Commercial |
$70.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.08
|
| Rate for Payer: UHC Core |
$69.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.28
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 1ST DOSE
|
Facility
|
OP
|
$524.28
|
|
|
Service Code
|
HCPCS M0249
|
| Hospital Charge Code |
77100044
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$124.52 |
| Max. Negotiated Rate |
$471.85 |
| Rate for Payer: Aetna Commercial |
$445.64
|
| Rate for Payer: Aetna Medicare |
$136.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$163.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$163.84
|
| Rate for Payer: BCBS Complete |
$325.67
|
| Rate for Payer: BCBS MAPPO |
$131.07
|
| Rate for Payer: BCBS Trust/PPO |
$407.63
|
| Rate for Payer: BCN Commercial |
$407.63
|
| Rate for Payer: BCN Medicare Advantage |
$131.07
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cofinity Commercial |
$450.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.07
|
| Rate for Payer: Healthscope Commercial |
$471.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.21
|
| Rate for Payer: Mclaren Medicaid |
$310.17
|
| Rate for Payer: Meridian Medicaid |
$325.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$150.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.64
|
| Rate for Payer: PACE Senior Care Partners |
$124.52
|
| Rate for Payer: PACE SWMI |
$131.07
|
| Rate for Payer: PHP Commercial |
$445.64
|
| Rate for Payer: PHP Medicare Advantage |
$131.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.12
|
| Rate for Payer: Priority Health Medicare |
$131.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$319.76
|
| Rate for Payer: Railroad Medicare Medicare |
$131.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.37
|
| Rate for Payer: UHC Core |
$437.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.07
|
| Rate for Payer: UHC Medicare Advantage |
$135.00
|
| Rate for Payer: VA VA |
$131.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.21
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 1ST DOSE
|
Facility
|
IP
|
$524.28
|
|
|
Service Code
|
HCPCS M0249
|
| Hospital Charge Code |
77100044
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$319.76 |
| Max. Negotiated Rate |
$471.85 |
| Rate for Payer: Aetna Commercial |
$445.64
|
| Rate for Payer: BCBS Trust/PPO |
$405.16
|
| Rate for Payer: BCN Commercial |
$405.16
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cofinity Commercial |
$450.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.42
|
| Rate for Payer: Healthscope Commercial |
$471.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.64
|
| Rate for Payer: PHP Commercial |
$445.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$319.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.37
|
| Rate for Payer: UHC Core |
$437.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.21
|
|
